Coaxial suction system for laser lipolysis

ABSTRACT

A surgical probe apparatus is disclosed including a handpiece which includes an optical system configured to deliver therapeutic light to provide treatment of an area of tissue; and at least one suction port configured to remove a byproduct of the treatment from the area of tissue in response to an applied vacuum.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. application Ser. No.12/135,970, filed Jun. 9, 2008, which claims benefit to each of U.S.Provisional Application Ser. No. 60/987,596, filed Nov. 13, 2007, U.S.Provisional Application Ser. No. 60/987,617, filed Nov. 13, 2007, U.S.Provisional Application Ser. No. 60/987,819, filed Nov. 14, 2007, U.S.Provisional Application Ser. No. 60/987,821, filed Nov. 14, 2007, U.S.Provisional Application Ser. No. 61/018,727, filed Jan. 3, 2008, U.S.Provisional Application Ser. No. 61/018,729, filed Jan. 3, 2008, andU.S. Provisional Application Ser. No. 60/933,736, filed Jun. 8, 2007,the contents each of which are incorporated by reference herein in theirentirety.

FIELD OF THE INVENTION

The present invention relates to a laser liposuction method. Moreparticularly, the present invention relates to a coaxial suction systemfor laser lipolysis.

BACKGROUND OF THE INVENTION

Plastic surgeons, dermatologists and their patients continually searchfor new and improved methods for treating the effects of an aging orotherwise damaged skin. One common procedure for rejuvenating theappearance of aged or photodamaged skin is laser skin resurfacing usinga carbon dioxide laser. Another technique is non-ablative laser skintightening, which does not take the top layer of skin off, but insteaduses a deep-penetrating laser to treat the layers of skin beneath theouter epidermal layer, tightening the skin and reducing wrinkles toprovide a more youthful appearance.

For such techniques for laser skin tightening treatment, it has beendifficult to control the depth and amount of energy delivered to thecollagen without also damaging or killing the dermal cells. Much of theenergy of the treatment pulse is wasted due to scattering and absorptionin the outer epidermal layer, and the relatively high pulse energyrequired to penetrate this outer layer can cause pain and epidermaldamage.

Some skin tightening techniques include using a hollow tubular cannulathat contains an optical fiber connected to a laser source. The cannulacan be inserted subcutaneously into a patient so that the end of thefiber is located within the tissue underlying the dermis. The sourceemits a treatment output, for example an output pulse that is conveyedby the fiber to the dermis, which causes collagen shrinkage within thetreatment area, thus tightening the skin.

To improve one's health or shape, patients have also turned to surgicalmethods for removing undesirable tissue from areas of their body. Forexample, to remove fat tissue, some patients have preferred liposuction,a procedure in which fat is removed by suction mechanism because despitestrenuous dieting and exercise, some of the patients cannot lose fat,particularly in certain areas. Alternatively, laser or other lightsources has been applied for heating, removal, destruction (for example,killing), photocoagulation, eradication or otherwise treating(hereinafter collectively referred as “treating” or “treatment”) thetissue.

Conventionally, both a skin tightening technique and a laser liposuctiontechnique requires two steps. First, a step to insert a first cannulacontaining a surgical waveguide through an incision point to heat andablate a target tissue with a laser. And second, a step to insert asecond cannula through the same incision point to suction out abyproduct from the first step.

In applications including those mentioned above, it is often desirableto monitor the temperature of a specific location, for example, alocation within a surgical field, in real time. Such monitoring mayprevent, for example, skin or other tissue damaged caused by, forexample, overheating.

SUMMARY OF THE INVENTION

The inventors have realized that for many applications it isadvantageous to simultaneously treat (e.g. with a laser) body fat orother suitable tissue and suction off the byproducts of the treatmentlaser-tissue interaction.

In some embodiments, a surgical probe apparatus includes a hand piece,where the hand piece itself includes an optical system configured todeliver therapeutic light to provide treatment of an area of tissue, andthe surgical probe further includes at least one suction port configuredto remove a byproduct of the treatment from the area of tissue inresponse to an applied vacuum. In some embodiments, at least one suctionport is located proximal to the distal end of the optical fiber. In someembodiments, at least one suction port is set back from the distal endof the optical fiber towards the proximal end of the optical fiber.

In some embodiments, the optical system includes an optical fiberextending between a proximal end adapted to receive therapeutic lightfrom a light source and a distal end adapted to emit said therapeuticlight into the area of tissue.

In some embodiments, the surgical probe further includes: a hollowtreatment cannula surrounding at least a portion of the optical fiber, ahollow suction cannula located proximal to the first cannula, the secondcannula comprising the at least one suction port and adapted to, inresponse to the applied vacuum direct byproduct through the suction portaway from the area of tissue.

The handpiece includes a handle, where the treatment cannula extendsfrom an end proximal the handle to an end distal the handle, and thesuction cannula extends from an end proximal the handle to an end distalthe handle. In some embodiments, the suction cannula surrounds at leasta portion of the treatment cannula.

In some embodiments, a portion of the treatment cannula proximal itsdistal end extends along a first axis and at least a portion of thesuction cannula proximal its distal end extends along a second axissubstantially parallel to said first axis. In some embodiments, at leasta portion of the exterior of the treatment cannula is in contact with atleast a portion of the exterior of the suction cannula. In someembodiments, at least a portion of the exterior of the treatment cannulais in contact with at least a portion of the interior of the suctioncannula.

In some embodiments, a tip of the end of the suction cannula distal tothe handle includes the at least one suction port. In some embodiments,a side of the suction cannula includes the at least one suction port. Insome embodiments, the suction cannula and the treatment cannula eachincludes a first portion proximal the handle and a second portion distalsaid handle, wherein the first portion of the treatment cannula ispositioned within but not coaxial with the first portion of the suctioncannula, and wherein the second portion of the treatment cannula ispositioned within and coaxial with the second portion of the suctioncannula.

In some embodiments, the distal end of the optical fiber is positionedsuch that substantially no therapeutic light emitted from said distalend impinges on the suction cannula. In some embodiments, the distal endof the optical fiber is positioned such that at least a portion of thetherapeutic light emitted from said distal end impinges on the suctioncannula.

In some embodiments, a vacuum unit is configured to selectively generatethe applied vacuum at the at least one suction port. In someembodiments, the vacuum unit is further configured to selectivelyproduce positive pressure at the at least one suction port.

In some embodiments, the surgical probe apparatus further includes asensor located proximal the distal end of the optical fiber, the sensoradapted to generate a signal indicative of one or more properties of thearea of tissue, a sensing cannula including the sensor, the sensingcannula extending from an end proximal the handle to an end distal thehandle.

In some embodiments, the sensor is a temperature sensor adapted togenerate a signal indicative of the temperature of the area of tissue.In some embodiments, the surgical probe apparatus further includes aprocessor adapted to receive the signal and control the delivery oftherapeutic light based on the signal.

In another embodiment, a method is defined including providing asurgical probe, where the surgical probe includes a hand piece, the handpiece itself including: an optical system configured to delivertherapeutic light and at least one suction port. The method furtherincludes inserting a portion of the surgical probe into a patientthrough an incision to an area of tissue, delivering therapeutic lightto treat the area of tissue using the optical system, and applying avacuum to the suction port to remove a byproduct of the treatment.

In some embodiments, the method includes defines the therapeutic lightas a laser light. In some embodiments, the laser light comprisesinfrared laser light.

In some embodiments, the hand piece includes a hollow treatment cannulasurrounding at least a portion of the optical delivery system and ahollow suction cannula located proximal to the first cannula, the secondcannula comprising the at least one suction port; where the applyingvacuum comprises applying vacuum to the suction cannula.

In some embodiments, the method further includes delivering therapeuticlight to a portion of the area of tissue located proximal to an end ofthe suction cannula, and advancing the end of the suction cannula intosaid portion of the area of tissue.

In some embodiments, the method further includes directing a portion ofthe treatment light onto the suction cannula to heat said suctioncannula and advancing the heated suction cannula through the a portionof the area of tissue.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other objects, features and advantages of theinvention will be apparent from the following more particulardescription of preferred embodiments of the invention, as illustrated inthe accompanying drawings in which like reference characters refer tothe same parts throughout the different views. The drawings are notnecessarily to scale, emphasis instead being placed upon illustratingthe principles of the invention.

FIG. 1 shows an embodiment of a surgical hand piece supporting asurgical waveguide and an independent suction unit.

FIG. 2 shows an block diagram of a laser liposuction system.

FIG. 3 shows a surgical hand piece where a treatment cannula supportinga surgical waveguide is interior to a suction unit cannula.

FIG. 4 shows a coaxial surgical waveguide and suction unit cannula,where a fiber optic line coupled to the surgical waveguide is displacedoff-axis, along the perimeter of the suction cannula.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

FIG. 1 shows an embodiment of a laser liposuction probe 100. The laserliposuction probe 100 includes a surgical hand piece 105 that supportsboth a surgical waveguide cannula 110 and a suction unit cannula 115.The surgical waveguide cannula 105 supports a surgical waveguide 120.The surgical waveguide 120 delivers energy through the liposuction probe100; the suction unit cannula 115 functions to remove a byproductthrough the liposuction probe 100.

In an exemplary embodiment of the laser liposuction probe 100, thesurgical hand piece 105 merges the surgical waveguide 120 and a suctiontube 125 into the surgical waveguide cannula 110 and the suction unitcannula 115, respectively. In some embodiments, the surgical waveguidecannula 110 may have a diameter of approximately 2-4 mm. In someembodiments, the suction unit cannula 115 may have a diameter ofapproximately 0.5-1.0 mm. In some embodiments, the surgical waveguide120 may be a fiber optic waveguide.

FIG. 2 shows a surgical hand piece 105 supporting a surgical waveguidecannula 110 and a suction unit cannula 115. A laser 230 provides energyto a treatment site 235 through the surgical waveguide 120. The laser230 provides energy in accordance with a controller 240. The controller240 may determine one or more of the following settings for the laser230: a laser power, a laser pulse repetition rate, a laser duty cycle,and a laser wavelength.

A suction system 245 provides a suction to remove a byproduct from thetreatment site 235 through the suction unit cannula 115. In someembodiments, the byproduct may be a fluid and/or an ablated tissue fromthe treatment site. The suction system 245 provides suction inaccordance with the controller 240. The controller 240 may determine oneor more of the following settings for the suction system 245: a suctionpressure, a suction aperture, a suction flow rate, and a suction pulserepetition rate.

The controller 240 may determine the one or more settings for the laser230 and the suction system 245 from a set of feedback data 250 from aset of sensors mounted on or in the hand piece 105. The set of feedbackdata 250 includes data taken from sensors including: a hand piece 105acceleration sensor, a hand piece 105 velocity sensor, a hand piece 105position sensor, a treatment site 235 temperature sensor, a treatmentsite 235 tissue type sensor, and a suction unit cannula 115 pressure.

FIG. 3 shows a surgical hand piece 305 where a surgical waveguidecannula 310 supports a surgical waveguide 320 interior to a suction unitcannula 315. Of course, any suitable arrangement of treatment andsuction cannulas is possible. Cross section (a) in FIG. 3 shows thesurgical waveguide cannula 310 positioned outside of the suction unitcannula 315. In some embodiments, as shown in cross sections (b)-(d) ofFIG. 3, the surgical waveguide cannula 310 is placed inside, either ofaxis or coaxial to, the larger suction unit cannula 315. A configurationwhere the surgical waveguide cannula 310 is placed inside the suctionunit cannula 315 has an advantageous external profile for, for example,pushing through a tissue, but the configuration may not offer the bestperformance for efficient fat suctioning.

Various embodiments may feature other suitable cross sectional profiles,as shown in cross sections (b)-(d) of FIG. 3. For various applications,a suitable profile can be chosen based on one or more considerations,including efficient aspirate (or other treatment byproduct) removal,probe resistance through tissue and fat, manufacturability, and cost.

In various embodiments, the surgical hand piece 305, the surgicalwaveguide cannula 310, and the suction unit cannula 315 are configuredto improve and optimize a laser treatment efficiency, for example, alaser tissue interaction and a laser tissue ablation. For example, insome embodiments, a surgical waveguide tip 321 (e.g. laser probe) is setin advance of a suction unit orifice 316 to heat and disrupt the targettissue in advance of a forward stroke performed by a surgeon.

In positioning the surgical waveguide tip 321 in advance of the suctionunit orifice 316, the surgical waveguide tip 321 is inhibited fromdirecting energy from the laser into the side of the suction unitcannula 315. Note however, in some embodiments, the surgical waveguidetip 321 can be intentionally positioned such that a portion of theenergy from the laser impinges the side of the suction unit cannula 315.For example, such a configuration may be used in applications where itis advantageous that the suction unit cannula 315 is to be heated by thelaser.

In various embodiments, a mechanical configuration of the surgicalwaveguide tip 321 and the suction unit orifice 316 may be chosen basedon considerations of the application at hand. As an example, themechanical configuration of the surgical waveguide tip 321 and thesuction unit orifice 316 may be chosen based on how the surgicalwaveguide tip 321 and the suction unit orifice 316 move through thetissue and how effectively the suction unit orifice 316 passes tissueand fluid and remains unclogged.

In some embodiments, the suction unit cannula 315 may include atemperature sensor 355. The temperature sensor 355 may be selected froma group including: a thermocouple, a thermistor, a pyrometer, and aninfrared (IR) thermal sensor.

FIG. 4 shows a coaxial surgical cannula 400. The coaxial surgicalcannula 400 includes a surgical hand piece 405, a surgical waveguidecannula 410, and a suction unit cannula 415, where an optical fiber 422coupled to a surgical waveguide 420 is displaced off-axis, along theperimeter of the suction unit cannula 415. In FIG. 4, the surgicalwaveguide 420 is positioned central to the end of both the surgicalwaveguide cannula 410 and the suction unit cannula 415, therebyimproving the energy distribution of the laser with respect to a coaxialsurgical cannula axis 401. In some embodiments, a circular cross sectionof the suction unit cannula 415 is preferred to allow for the best flowof ablated tissue and fluid.

As shown in FIG. 4, the surgical waveguide cannula 410 deflects from thecoaxial surgical cannula axis 401 at or near a surgical waveguide tip421 to an axis displaced from the coaxial surgical cannula axis 401along the perimeter of the suction unit cannula 415. The geometry ofFIG. 4 allows for the addition of a temperature probe 455 to theinterior of the suction unit cannula 415. The temperature probe 455 maybe selected from the following: a thermister, a thermocouple, apyrometer, and an infrared (IR) thermal sensor.

In various embodiments, the size and shape of a set of aspiration ports460 in the suction unit cannula 415 and the suction pressure may be afunction of a given application. For example, a byproduct of a set ofstandard liposuction surgeries and laser liposuction surgeries may bedifferent. A standard liposuction may produce a byproduct with a chunky‘cottage cheese’ texture, while a laser lipolysis may result in a lesschunky byproduct, with a ‘smoothie’ consistency.

The size and shape of the set of aspiration ports 460 may be selectedbased on the consistency of the liposuction and lypolysis byproduct. Forexample, for a typical laser lipolysis applications, the set ofaspiration ports 460 may be chosen to be smaller and more numerouscompared to aspiration ports for a standard liposuction. In someembodiments, to prevent clogging, the suction vary between suction and abrief high pressure pulse to disrupt clogs (i.e. a plunger effect).

While various embodiments have been particularly shown and describedabove, it will be understood by those skilled in the art that variouschanges in form and details may be made therein without departing fromthe scope of the invention.

For example, it is to be understood that although in the examplesprovided above laser light is used for treatment, other sources oftreatment light (e.g. flash lamps, light emitting diodes) may be used.

In some embodiments, a safety accelerometer may be incorporated in asurgical waveguide assembly. For example, an accelerometer may beincluded within a sterile sheath and attached to, for example, the handpiece assembly. The accelerometer may be attached to for example, anelectronic processor via wiring contained in the sterile sheath. Duringtreatment, the accelerometer measures acceleration of the hand piece andmay determine, for example, if the hand piece has come to rest in asingle position for too long a period of time, potentially leading tounsafe heating levels, triggering, for example, a warning, or treatmentlaser shut off.

In various embodiments, other safety devices (e.g. position sensors,temperature sensors, etc.) may similarly be incorporated with thesurgical waveguide and hand piece. Control systems may processinformation from these safety sensors and control (e.g. shut off) theapplied treatment light based on this information.

One or more or any part thereof of the treatment, sensing, or safetytechniques described above can be implemented in computer hardware orsoftware, or a combination of both. The methods can be implemented incomputer programs using standard programming techniques following themethod and figures described herein. Program code is applied to inputdata to perform the functions described herein and generate outputinformation. The output information is applied to one or more outputdevices such as a display monitor. Each program may be implemented in ahigh level procedural or object oriented programming language tocommunicate with a computer system. However, the programs can beimplemented in assembly or machine language, if desired. In any case,the language can be a compiled or interpreted language. Moreover, theprogram can run on dedicated integrated circuits preprogrammed for thatpurpose.

Each such computer program is preferably stored on a storage medium ordevice (e.g., ROM or magnetic diskette) readable by a general or specialpurpose programmable computer, for configuring and operating thecomputer when the storage media or device is read by the computer toperform the procedures described herein. The computer program can alsoreside in cache or main memory during program execution. The analysismethod can also be implemented as a computer-readable storage medium,configured with a computer program, where the storage medium soconfigured causes a computer to operate in a specific and predefinedmanner to perform the functions described herein.

A number of embodiments of the invention have been described.Nevertheless, it will be understood that various modifications may bemade without departing from the spirit and scope of the invention.

For example, it is to be understood that although in the examplesprovided above laser light is used for treatment, other sources oftreatment light (e.g. flash lamps, light emitting diodes) may be used.

As used herein the term ‘light’ is to be understood to includeelectromagnetic radiation both within and outside of the visiblespectrum, including, for example, ultraviolet and infrared radiation.

While the invention has been described in connection with the specificembodiments thereof, it will be understood that it is capable of furthermodification. Furthermore, this application is intended to cover anyvariations, uses, or adaptations of the invention, including suchdepartures from the present disclosure as come within known or customarypractice in the art to which the invention pertains, and as fall withinthe scope of the appended claims.

All publications, patents, and patent applications mentioned in thisspecification are herein incorporated by reference to the same extent asif each individual publication, patent, or patent application wasspecifically and individually indicated to be incorporated by reference.

1. A surgical probe apparatus comprising: a handpiece comprising: anoptical system configured to deliver therapeutic light to providetreatment of an area of tissue; and at least one suction port configuredto remove a byproduct of the treatment from the area of tissue inresponse to an applied vacuum.
 2. The apparatus of claim 1, wherein theoptical system comprises an optical fiber extending between a proximalend adapted to receive therapeutic light from a light source and adistal end adapted to emit said therapeutic light into the area oftissue, and wherein the at least one suction port is located proximal tothe distal end of the optical fiber.
 3. The apparatus of claim 2,wherein the at least one suction port is set back from the distal end ofthe optical fiber towards the proximal end of the optical fiber.
 4. Theapparatus of claim 2, further comprising: a hollow treatment cannulasurrounding at least a portion of the optical fiber; a hollow suctioncannula located proximal to the first cannula, said second cannulacomprising the at least one suction port and adapted to, in response tothe applied vacuum direct byproduct through the suction port away fromthe area of tissue.
 5. The apparatus of claim 4, wherein the handpiececomprises a handle, and wherein the treatment cannula extends from anend proximal the handle to an end distal the handle, and the suctioncannula extends from an end proximal the handle to an end distal thehandle.
 6. The apparatus of claim 5, wherein the suction cannulasurrounds at least a portion of the treatment cannula.
 7. The apparatusof claim 5, wherein at least a portion of the treatment cannula proximalits distal end extends along a first axis and at least a portion of thesuction cannula proximal its distal end extends along a second axissubstantially parallel to said first axis.
 8. The apparatus of claim 7,wherein at least a portion of the exterior of the treatment cannula isin contact with at least a portion of the exterior of the suctioncannula.
 9. The apparatus of claim 7, wherein at least a portion of theexterior of the treatment cannula is in contact with at least a portionof the interior of the suction cannula.
 10. The apparatus of claim 5,wherein a tip of the end of the suction cannula distal the handlecomprises the at least one suction port.
 11. The apparatus of claim 5,wherein a side of the suction cannula comprises the at least one suctionport.
 12. The apparatus of claim 5, wherein the suction cannula and thetreatment cannula each comprise a first portion proximal the handle anda second portion distal said handle, wherein the first portion of thetreatment cannula is positioned within but not coaxial with the firstportion of the suction cannula, and wherein the second portion of thetreatment cannula is positioned within and coaxial with the secondportion of the suction cannula.
 13. The apparatus of claim 5, whereinthe distal end of the optical fiber is positioned such thatsubstantially no therapeutic light emitted from said distal end impingeson the suction cannula.
 14. The apparatus of claim 5, wherein the distalend of the optical fiber is positioned such that at least a portion ofthe therapeutic light emitted from said distal end impinges on thesuction cannula.
 15. The apparatus of claim 1, further comprising avacuum unit configured to selectively generate the applied vacuum at theat least one suction port.
 16. The apparatus of claim 15, wherein thevacuum unit is further configure to selectively produce positivepressure at the at least one suction port.
 17. The apparatus of claim 5,further comprising a sensor located proximal the distal end of theoptical fiber, said sensor adapted to generate a signal indicative oneor more properties of the area of tissue; a sensing cannula comprisingsaid sensor, said sensing cannula extending from an end proximal thehandle to an end distal the handle.
 18. The apparatus of claim 17,wherein the sensor is a temperature sensor adapted to generate a signalindicative of the temperature of the area of tissue.
 19. The apparatusof claim 18, further comprising a processor adapted to receive thesignal and control the delivery of therapeutic light based on thesignal.
 20. A method comprising: providing a surgical probe comprising ahandpiece comprising: an optical system configured to delivertherapeutic light; and at least one suction: port inserting a portion ofthe surgical probe into a patient through an incision to an area oftissue; using the optical system, delivering therapeutic light to treatthe area of tissue; applying vacuum to the suction port to remove abyproduct of the treatment.
 21. The method of claim 20, wherein thetherapeutic light comprises laser light.
 22. The method of claim 21,wherein the laser light comprises infrared laser light.
 23. The methodof claim 20, wherein the handpiece comprises a hollow treatment cannulasurrounding at least a portion of the optical delivery system; and ahollow suction cannula located proximal to the first cannula, saidsecond cannula comprising the at least one suction port; and wherein theapplying vacuum comprises applying vacuum to the suction cannula. 24.The method of claim 23, further comprising: delivering therapeutic lightto a portion of the area of tissue located proximal to an end of thesuction cannula, and advancing the end of the suction cannula into saidportion of the area of tissue.
 25. The method of claim 23, furthercomprising: directing a portion of the treatment light onto the suctioncannula to heat said suction cannula; advancing the heated suctioncannula through the portion of the area of tissue.